Wednesday, April 25, 2007

According to an Associated Press article published Monday in the Boston Globe, a new study has shown that "fat workers cost employers more." AP writer Carla K. Johnson writes that: "Overweight workers cost their bosses more in injury claims than their lean colleagues, suggests a study that found the heaviest employees had twice the rate of workers' compensation claims as their fit co-workers."

"Duke University researchers also found that the fattest workers had 13 times more lost workdays due to work-related injuries, and their medical claims for those injuries were seven times higher than their fit co-workers. Overweight workers were more likely to have claims involving injuries to the back, wrist, arm, neck, shoulder, hip, knee and foot than other employees. The findings were based on eight years of data from 11,728 people employed by Duke and its health system. Researchers found that workers with higher body mass indexes, or BMIs, had higher rates of workers' compensation claims. The most obese workers -- those with BMIs of 40 or higher -- had the highest rates of claims and lost workdays."

The study was published in the current issue of Archives of Internal Medicine.

Based on these findings, the authors of the study recommended that employers institute fitness programs to help their overweight employees lose weight.

In response to the study: "New York employment attorney Richard Corenthal cautioned employers not to overreact with discriminatory policies. 'Employers need to be careful not to view this study as a green light to treat obese or overweight workers differently,' Corenthal said."

The Rest of the Story

The rest of the story here is not the study itself, but the response to the findings. And the story is not what researchers recommended, but what they did not recommend. You don't hear anyone suggesting that to save health care and workers compensation money, employers fire fat people or stop hiring them in the first place. It simply isn't part of the discourse. The suggestion simply does not arise. No public health groups are suggesting - or would suggest - anything of the sort. The response (and an appropriate one) is to recommend fitness or other programs to help employees control their weight.

Not so with an almost identical problem - off-the-job employee smoking. That problem is also costing employers money in terms of health care costs. However, in contrast to the obesity and overweight problem, many anti-smoking groups are supporting the idea of firing smokers or refusing to hire smokers in order for employers to save money. The World Health Organization has gone so far as to institute its own smoker-free employment policy, refusing to consider applications from smokers for any WHO job.

It is time that anti-smoking groups understand that the precise reasoning they are using to support discrimination against smokers in employment also supports discrimination against obese and overweight people. If we are going to support the idea of excluding smokers from employment to save health care costs for employers, then we must also support the idea of excluding fat people from employment.

Another aspect to the rest of the story is the immediate and vigorous way in which the mere possibility of employers discriminating against overweight people is confronted. The article concludes with a caution to employers not to take these findings as a green light to discriminate against overweight job applicants.

Not so with smoker-free employment policies. You generally are not hearing a vigorous response warning employers not to discriminate against smokers. You certainly will not hear such a warning from any U.S. anti-smoking group.

In fact, I might go so far as to say that my greatest disappointment right now as a tobacco control advocate is the failure of any U.S. anti-smoking group to step up and condemn discrimination against smokers in employment. I don't think that discrimination is something we should be supporting or even condoning in the tobacco control movement. The fact that we are supporting it is a grave disappointment to me, and it makes me quite ashamed to be a tobacco control practitioner and a part of that movement.

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About Me

Dr. Siegel is a Professor in the Department of Community Health Sciences, Boston University School of Public Health. He has 32 years of experience in the field of tobacco control. He previously spent two years working at the Office on Smoking and Health at CDC, where he conducted research on secondhand smoke and cigarette advertising. He has published nearly 70 papers related to tobacco. He testified in the landmark Engle lawsuit against the tobacco companies, which resulted in an unprecedented $145 billion verdict against the industry. He teaches social and behavioral sciences, mass communication and public health, and public health advocacy in the Masters of Public Health program.